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Eye Conditions – Cataracts

What is a cataract?

If your doctor has told you that you have a cataract, don’t be alarmed. Over half of those over 65 have some cataract development and most cases can be treated successfully with surgery. Despite what you may have heard, a cataract is not a skin that grows over your eye. A cataract is a clouding of part of your eye called the lens. Your vision becomes blurred or dim because light cannot pass through the clouded lens to the back of the eye.

The lens

The lens is a transparent body behind the iris, the coloured part of the eye. The lens bends light rays so that they give a clear image to the back of the eye – the retina. As the lens is elastic, it will change shape for distant objects.

What causes a cataract?

Cataracts can form at any age, but most often develop as people get older. In younger people they can result from an injury, certain drugs, long-standing inflammation or illnesses such as diabetes.

Some symptoms

“I’m not seeing as well as I used to”
You may notice that some things seem blurred round the edges, or that your glasses seem dirty or scratched.

Seeing double
The cloudiness in the lens may occur in more than one place, so that the light rays which reach the retina are split, causing a double image.

Poor vision in bright light
You may find that bright light or very sunny days make it more difficult to see.

Change of colour vision
As the cataract develops, its centre becomes more and more yellow, giving everything you see a yellowish tinge

What can be done to help?

The most effective treatment for cataracts is a small operation to remove the cloudy lens. This cannot be performed by laser, although laser treatment is sometimes needed afterwards. Diets or drugs have not been shown to slow or stop the development of cataracts.

What is a lens transplant?

When the cloudy lens has been surgically removed it is usually replaced by a plastic lens so that the eye can focus properly. Occasionally a doctor will decide that someone’s eye is not suitable for a lens transplant. In these cases contact lenses or special glasses will be prescribed instead.

When should I have the operation?

Usually you can decide if and at what stage to have the operation. But obviously you need to bear in mind that there may be a waiting list for this.

In the past, eye specialists often waited until the cataract became “ripe” before suggesting you had it removed. Nowadays, with modern surgery the operation can be carried out at any stage of the cataract’s development. If visual impairment interferes with your ability to read, work or do the things you enjoy, then you will probably want to consider surgery.

For most people, it is possible to have the operation and go home on the same day, as long as you have someone to look after you at home. Sometimes surgery will mean a short stay in hospital.

What happens in the operation?

Just before the operation you will be given eye drops to enlarge your pupil and, if you desire, something to help you relax. Normally cataract surgery is performed with a local anaesthetic and some sedation. The local anaesthetic numbs the area that is being operated on. You will be wide awake but feel noting in your eye. Usually the eye specialist will explain what is happening as the operation proceeds, and a nurse will be there to hold your hand and make sure you are alright.

Sometimes your doctor may decide to give you a general anaesthetic. This means that you are completely unconscious, and it will be like sleeping through an operation.

The operation is performed with the aid of a microscope through a small cut in the top of the eye. This is closed using small stitches at the end of the operation. The operation generally takes up to 45 minutes. A pad or shield will probably be put over your eye to protect it from accidental rubbing and bumping after the operation.

We want to reassure you that your eye is not taken out of its socket during surgery. The operation is not painful and the stitches cannot be seen.

After the operation

Your sight will usually improve within a few days, although complete healing may take several months. It is a good idea to have some help at home if you can, especially if you find it difficult to put your eye drops in. You will need to take it easy for a couple of weeks so that your eye can heal.

Avoid rubbing your eye, and wear an eyeshield if you are a restless sleeper.

Don’t do any heavy lifting, and avoid strenuous exercise and swimming.

You can do light housework or cooking, but try to get some help if you can.

You don’t need to stay indoors, but take care if it is windy in case anything blows in your eye.

Wash your hair leaning backwards rather than forwards.

Avoid eye make-up for six weeks.

You can resume your sex life a week or two after the operation.

Avoid driving until your surgeon tells you it is safe.

New glasses are usually prescribed four to eight weeks after the operation.

How long you are off work will depend on the job you do. Ask your eye specialist about this.

The information provided here is intended to educate the reader about certain medical issues and should not be used for clinical diagnosis.